anemia...next step

[Ironpony]

I just learned I'm down to about an 8 for hgb. I start week 9 tomorrow of triple with Inc. I am waiting for the Dr to call back. I was already reduced from 1000 riba to 800 mg in my 5th week due to anemia. What is his likely next step?

[hrsepwrguy]

"juice some green veggies 3 times per day you wil be fit as a fiddle"

That shows just how little you actually know about hemolytic anemia

Laura follow your doctors orders
Have a great day
HPG

[Ironpony]

Thanks....I was so ready to exit the hospital I never got to ask about what it means.
I do think that now I have had the transfusion I will get through these last 3 weeks of incivek with no problem..do you're right that is doing pretty good:) I really feel badly for those that got the bad rash and had to make it through each week....that must have been torture!
Thanks for explaining the numbers to me:)
Laura

[flcyclist]

Your doctor will watch your wbc and absolute neutrophil count (anc) as you go through tx.  The ANC is monitored for the risk of infection, especially in cancer tx patients.  However, there isn't a strong correlation between a low ANC and HCV patients, so there is some debate on how low it can go before intervention.  The more experienced doctors often use an ANC of 0.5, while some still use 1.0.   If it goes belows these levels, the choice is either the rescue drup, neupogen, or a dose reduction of interferon.  There is no set protocol and how to handle this is all a bit controversial on the best approach.

You appear to be doing pretty well so far, so hope none of this is needed.   You have enough going on for now.  Good luck with the remainer of tx.

[Ironpony]

No the lowest mine dropped to was 8.1 I seriously cannot imagine what the 7's are like and I hope I never get to see! 3 more weeks of incivek and then. he wants to raise my riba. I know my wbc is low 2.4 as well I don't know what that means though.

[belle19]

happy for your 8 week results.  my doctor said NOT to take iron while on tx.  he said it wouldn't help at all.  i'm sending you hugs and prayers.  take care.  belle

[Greta2012]

Yeah on your 8 week results!  Hopefully you are home now resting....

[BoceprevirGal]

Oh, also.. this is addressed to Ironpony: Did you ever find out how low your HGB had dropped to. I know you said it was 8 at 8 weks, and you are now at 9 weeks, so I was wondering if it had gone as low as 7.5.
    Also hoping your Doctor will start you on Procrit, but I know you havent spoken to your Hep Doc yet, but still cant figure why he(she) let you get so anemic~

[1oftheclub222]

this kind of enemia is not related to iron i believe, I think our RBC are just getting used faster then we can reproduce them.  We should be careful about advising people to take iron, it depends on the condition of their liver...if their liver is in bad shape (cirrhosis), i think it is not safe to take iron, the liver has a hard time processing it.

[joey48]

I understand your pain ,, I  had to have a blood infusion [2units] and i feel so much better.  i was so messed up that i couldent even climb one flight of steps without giveing out. they reduced my riba from 1200 a day to 800 a day . and now my plattlet count is way low now they reduced my peg
Take iron pills every day ,,eat red meat if you can. [joey48]

[Idyllic]

My little sister has the same thing with her heart. She had a good, comprehensive cardio work up and her stress test and EKG showed no abnormalities so her Cardi told her a mild mitral valve regurg. is nothing to worry about. Still, she is followed fairly closely.  He said she may have to take a mild diuretic to relieve occassional fluid accumulation in her arms and legs but she follows a low-salt diet. Her BP has always been good so basically it's observation for her since she is asymptomatic. The thing is: you were not and you had chest pains. I would be interested to see if your doctor thinks there is any possible way the severity of your Anemia could have exacerbated the situation.

Sorry to hear your are in hospital until this evening. Maybe you can pick up your darts tomorrow!!  :)

[nygirl7]

Laura I have the same problem with my heart, it's just a heart murmur and usually nothing at all a little bit of the blood just spits back out or something.
But it's definitely something I would keep an eye on until a doctor said that is all it is.

OK going out to get the steaks now!  :)

[LookingForward12]

Congrats on the eight week UND! And so glad you are feeling better with lots of new little red blood cells running around those veins!

[BoceprevirGal]

Heyyy...congrats on UND at 8 weeks, that is such great news, and makes it all soo worth it.  Bloody steaks for all!!
    Good to keep an eye on the heart valve "regurge", hopefully that will resolve after your treatment, and they also have medication for that, which prob does something like thins the blood a small amount, which would resolve that issue, etc~

[jules2551]

Laura, congrats on the UND.  Yes we will party tonight and bloody steaks for everyone! Take care of yourself

Jules

[Ironpony]

*wonder

[Ironpony]

The bad: echo showed mild regurgitation from the valves...was told this is "something "to watch" as I get older. I had a normal echo 3 years ago so I wander is anemia caused that?
I did throw up on myself (in bed) this am after I took my morning fat.
I am still in hospital til tonight if all other tests look good.(home to a shot:()
I got a procrit shot and did not like the burn from it!

The Good:
Transfusion was great. My fingertips and organs can breathe again. May get more as an outpatient if I crash again.
I got through every dose of incivek without knocking out a nurse. ;p


NY here's my card for bloody steaks tonight....it's a party because my 8 week VL  just came back UND too!!! ;p

Thanks everyone for the care ;)
Laura

[BoceprevirGal]

I'm so glad you are getting well taken care of. If you are not out of the hospital by now, you better send someone over to your house, to get your Inf shot~ that way you wont have to worry, and can focus on feeling better. I know it cant be fun, getting a blood transfusion, and you dont need the added stress, of worrying about your other meds.
   The good thing is: you brought your Incivek stash!  The other two, Interferon and Ribavirin, dont have the "tolerance issue" that the P.I. does, so they are not as important to take exactly on time....sending you healing vibes~

[rexx73]

before my transfusion i expected to feel much much better,like new born,but i just felt better,but not that big diffrence i expected.

later with the epo i started to feel better and better.
at work i was able again to climb the steps up to the office much quicker and with no break,before i climbed these stairs like in slowmotion.

[1oftheclub222]

Hope your feeling better today!

[nygirl7]

Hoping you are at home resting feeling much better today Laura. Wow look at all this I missed while I was sleeping.

Maybe we can do the bbq tonight since you'll be up and about after having feasted on some nice human blood - I'll bet you will start wanting that steak rare instead of medium now ;)

[Dee1956]

Hoping you will feel a little better soon, now that your Riba has been reduced it should make a difference
You should see my home, it is a wreck and at 2 months post I am trying to shovel it out.  I have felt like a good candidate for a TV show as well, wonder if they would clean for me?
Hang in there, just take care of your self.  That is the most important right now, you will get better
Best of luck
Dee

[rexx73]

i had/have also anemia problems too.at week 11 in triple treatment with incivek.
my hgb went down to 7.0.i had to stop riba for 2 days.after these 2 days it went up to 7.4 and i became 2 units of blood.
at the same time i started epo
first 10 000 twice a week ,later 30 000.my hgb went up to 10 then 11.7 and finally 12.9.
when i was.at 11.7 my doc lowered my epo dose to 300 but it still gone up to 12.9.now after a few weeks with 3000 my hgb is 11.8 and i hope it will stay around 10-12.

[Idyllic]

So glad you did this! Based on Bovary's post you may very well be feeling a little better within a few hours. I am reluctant to report any kind of a questionable side myself in fear of Riba dose reduction but man-o-man your hgb was so bloody low! I hope you are able to get a little restorative sleep and can post later on today so we know how you are feeling and how well the transfusion worked/ Take care Dol!

[Bovary73]

"My shots are at home and tomorrow is dart night. how long does this last usually? ."

The first time I had transfusion (two units) it took about 3 hours. Now they speed up and it takes about 2 hours. They say that normally, if a patient is having a transfusion, they use about 2 hours per unit. But as the nurse said (I blushed of this compliment...lol) because I'm so "young and healthy"...lol, she could speed it up a bit.

As long as you don't have any heart or lung desease they can speed it up a bit. But the first times they are more causious because of allergic reactions etc. Make sure to tell them if you get shills or feel dizzy.

in my case I felt wonderful right after getting the blood and for the first time in my life, I truly understand Vampire's desire for fresh blood. At first I was sceptic about receiving others blood, but after having the wonderful effect of it, I just love it / need it :)

You will probably feel much better soon! I went right home and washed all the windows after the first transfusion and felt so happy and "normal" for a while :)